Healthcare Provider Details

I. General information

NPI: 1518812882
Provider Name (Legal Business Name): JOSEPH NATHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2241 JERROLD AVE
SAN FRANCISCO CA
94124-1011
US

IV. Provider business mailing address

4229 LINCOLN WAY
SAN FRANCISCO CA
94122-1231
US

V. Phone/Fax

Practice location:
  • Phone: 415-558-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberP46181
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: